NPIMap

Organization Active NPI

Jeff Weber, Ed.D., P.C.

  • Psychologist
  • Suwanee, GA
National Provider Identifier
1245566603
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2094 Issued in GA
Legal business name
JEFF WEBER, ED.D., P.C.
Practice address
4411 Suwanee Dam Rd
Suite 920
Suwanee, GA 30024-8701
Phone
(678) 714-9590
Fax
(678) 714-9535
NPI assigned
Oct 20, 2009
Last updated
Oct 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie Weber, RN
Title
Offie Manager
Phone
(404) 642-2725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2094 GA Primary

Addresses

Primary practice location

4411 Suwanee Dam Rd
Suite 920
Suwanee, GA 30024-8701

Mailing address

4411 Suwanee Dam Rd
Suite 920
Suwanee, GA 30024-8701
Phone (678) 714-9590

Other identifiers 2

IdentifierTypeStateIssuer
66BBFHBOtherGAMEDICARE
007720544EMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1245566603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SUWANEE DAM RD",
            "address_2": "SUITE 920",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248701",
            "telephone_number": "678-714-9590",
            "fax_number": "678-714-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SUWANEE DAM RD",
            "address_2": "SUITE 920",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248701",
            "telephone_number": "678-714-9590",
            "fax_number": "678-714-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF WEBER, ED.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OFFIE MANAGER",
        "authorized_official_telephone_number": "404-642-2725",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "2094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "66BBFHB",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007720544E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.